Limited (L4-S1, L5-S1) selective dorsal rhizotomy for reducing spasticity in cerebral palsy

摘要: Selective posterior rhizotomy is effective for relieving spasticity associated with cerebral palsy. In current techniques dorsal roots from L1/L2 to S1/S2 are selectively divided. With transoperative electromyography (EMG) significant sensory loss has been prevented, but postoperative hypotonia following excessive reduction of the fusimotor drive still concern surgeons and therapists. To decrease volume deafferentiated rootlets we proposed a limited selective (LPSR) that limits extent surgery three (L4-S1) or two (L5-S1) roots. We present results group spastic children; 1 (n=59, 32 quadriplegic 27 diplegic) who had L4-S1 LPSR. 2 (n=12) in whom L5 S1 were rhizotomized. Posture, passive movilization, range joint movement, muscle tone hip flexors, adductors, leg flexors plantar graded according method by Sindou Jeanmonod. all groups there was mentioned parameters (Friedman test p<0.001) at 6, 12 18 months after surgery. The preoperative ability ambulate classified into five grades. (χ2 between p<0.01 improvement quality their gait. A third patients achieved some form independent ambulation. Our suggest extensive deafferentation lower limbs not an absolute requisite reducing achieving functional children.